Xing Fubao, Zhang Lei, Tang Zhen, Li Xiaojun, Gong Huiyuan, Wang Biao, Hu Yannan
Department of Thoracic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2021 Jan 30;41(1):146-150. doi: 10.12122/j.issn.1673-4254.2021.01.22.
To investigate the effect of thoraco-laparoscopic esophagectomy on postoperative immune function of patients with esophageal carcinoma.
Eighty-one patients undergoing radical esophagectomy in our hospital between January, 2017 and December, 2019 were enrolled in this study.According to the surgical approach, the patients were divided into endoscopic group (41 cases) and open surgery (3 incisions) group (40 cases).The immunological indicators (CD3, CD4, CD8, and CD4/CD8ratio) of the patients were analyzed using double antibody sandwich enzyme-linked immunosorbent assay at 1 day before the surgery and on days 1, 4 and 7 after the surgery.The plasma levels of interleukin 6(IL-6) and cortisol, β-endorphin (β-EP) level, white blood cell count (WBC) and C-reactive protein (CRP) levels of the patients were measured before and on days 1 and 7 after the operation.
No death occurred in either of the group after the operation.On days 4 and 7 after the operation, CD3, CD4, CD8, and CD4/CD8ratio were significantly higher in patients undergoing thoracolaparoscopic surgery than in those receiving open surgery ( < 0.05).In both groups, the levels of cortisol, β-EP, WBC, CRP and IL-6 measured on days 1 and 7 postoperatively were significantly different from those before the operation ( < 0.05).At all the indicated postoperative time points, all the measured indicators, with the exception of IL-6 levels on postoperative day 7, which were comparable between the two groups, were significantly higher in the open surgery group than in the endoscopic group ( < 0.05).
Thoraco-laparoscopic resection of esophageal cancer can reduce postoperative secretion of proinflammatory factors, alleviate inflammatory responses, and promote the recovery of immune functions to accelerate postoperative recovery of the patients.
探讨胸腹腔镜联合食管癌切除术对食管癌患者术后免疫功能的影响。
选取2017年1月至2019年12月在我院接受根治性食管癌切除术的81例患者纳入本研究。根据手术方式，将患者分为内镜组（41例）和开放手术（三切口）组（40例）。采用双抗体夹心酶联免疫吸附法分析患者术前1天及术后第1、4、7天的免疫指标（CD3、CD4、CD8及CD4/CD8比值）。测定患者术前及术后第1天和第7天的血浆白细胞介素6（IL-6）、皮质醇、β-内啡肽（β-EP）水平、白细胞计数（WBC）及C反应蛋白（CRP）水平。
两组术后均无死亡病例。术后第4天和第7天，胸腹腔镜手术患者的CD3、CD4、CD8及CD4/CD8比值显著高于开放手术患者（P<0.05）。两组术后第1天和第7天测定的皮质醇、β-EP、WBC、CRP及IL-6水平与术前相比均有显著差异（P<0.05）。在所有指定的术后时间点，除术后第7天两组IL-6水平相当外，开放手术组所有测定指标均显著高于内镜组（P<0.05）。
胸腹腔镜联合食管癌切除术可减少术后促炎因子分泌。减轻炎症反应，促进免疫功能恢复，加速患者术后康复。
